FDA Box Warning

• Abnormal serum potassium elevation may occur, and is more likely in patients with renal impairment or diabetes and in elderly or severely ill patients. As uncorrected hyperkalemia may be fatal, monitor serum potassium levels frequently, especially when dosage is changed or patient has an illness that may influence renal function.

Patient monitoring

Patient teaching

• Advise patient to take after meals to reduce nausea.• Instruct patient to take last daily dose in early evening to avoid nocturia.• Teach patient to recognize and report signs and symptoms of electrolyte imbalances.• Tell patient to avoid salt substitutes. Advise him not to use herbs without consulting prescriber.• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and herbs mentioned above.

triazolam

Apo-Triazo (CA), Gen-Triazolam (CA), Halcion

Pharmacologic class: Benzodiazepine

Therapeutic class: Sedative-hypnotic

Controlled substance schedule IV

Pregnancy risk category X

Action

Inhibits gamma-aminobutyric acid, a neurotransmitter that activates receptors at limbic, thalamic, and hypothalamic levels of CNS

Availability

Tablets: 0.125 mg, 0.25 mg, 0.5 mg

⊘Indications and dosages

➣ Insomnia

Adults: 0.125 to 0.5 mg P.O. at bedtime p.r.n. After 7 to 10 days, decrease dosage gradually and then discontinue.

Dosage adjustment

• Elderly or debilitated patients

Off-label uses

• Presurgical hypnotic

Contraindications

• Hypersensitivity to drug or other benzodiazepines• Concurrent use of itraconazole, ketoconazole, or nefazodone• Pregnancy

Precautions

Use cautiously in:• hepatic or renal dysfunction, sleep apnea, respiratory compromise, psychosis• history of suicide attempt or drug abuse• elderly or debilitated patients• breastfeeding patients• children younger than age 18 (safety and efficacy not established).

Patient monitoring

Patient teaching

• Tell patient to take at bedtime with a liquid other than grapefruit juice.• Explain that drug is meant only for short-term use (7 to 10 days).• Tell patient rebound insomnia may occur for 1 to 2 nights after he discontinues drug.• Instruct patient to avoid alcohol use and smoking.• Caution patient to avoid driving and other hazardous activities while under drug's influence.• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, foods, herbs, and behaviors mentioned above.

trifluoperazine hydrochloride

Action

Unknown. Thought to act on subcortical levels of hypothalamic and limbic systems by producing antidopaminergic effects. Also lowers seizure threshold and exhibits some adrenergic, muscarinic, and anticholinergic activity.

Availability

Children ages 6 to 12: Initially, 1 mg P.O. once or twice daily in hospitalized patients or those under close supervision; may increase gradually up to 15 mg/day P.O. until symptoms are controlled or adverse reactions are intolerable.

Patient teaching

• Tell patient that drug's full effect usually occurs in 1 to 2 weeks.• Instruct patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure drop.

☞ Teach patient to recognize and immediately report signs and symptoms of NMS and tardive dyskinesia.• Caution patient to avoid driving and other hazardous activities until he knows how drug affects him.• Tell patient to avoid alcohol and certain herbs.• Advise patient to avoid sun exposure and to wear sunscreen and protective clothing when going outdoors.• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.

Patient teaching

• Instruct patient to take with meals or, if severe dry mouth occurs, before meals.• Tell patient drug has a bitter taste, which may be followed by numbness and tingling in mouth.• Stress importance of follow-up eye exams.• Instruct patient to consult prescriber before taking over-the-counter preparations or herbs.• Advise patient to avoid alcohol and hazardous activities during drug therapy.• Tell patient to move slowly when sitting up or standing, to avoid dizziness from sudden blood pressure decrease.• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

Patient teaching

• Advise patient to take as needed for nausea and vomiting, but only as prescribed.• Tell patient to contact prescriber promptly if nausea persists despite therapy.• Instruct patient to minimize nausea and vomiting by eating small, frequent servings of healthy food and drinking plenty of fluids.• Advise patient to avoid alcohol.• Caution patient to avoid driving and other hazardous activities until drug effects are known.• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

Patient monitoring

☞ Monitor patient for signs and symptoms suggestive of cardiovascular disease and manage as appropriate.

Patient teaching

• Explain drug therapy to patient. Stress need for follow-up laboratory tests.• Tell patient prostate cancer symptoms may worsen during first few weeks of therapy.• Instruct patient to monitor weight and report sudden weight gain or leg swelling.• Advise female patient to tell prescriber before starting therapy if she is or plans to become pregnant. Caution her not to breastfeed during therapy.• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

tromethamine

Tham

Pharmacologic class: Protein substrate

Therapeutic class: Systemic alkalizer

Pregnancy risk category C

Action

Combines with hydrogen ions to form bicarbonate and a buffer, correcting acidosis. Also shows some diuretic activity.

Adults: 3.6 to 10.8 g by I.V. injection into large peripheral vein if chest isn't open, or 2 to 6 g I.V. directly into ventricular cavity if chest is open. After reversal of cardiac arrest, patient may need additional amounts to control persistent acidosis.

Patient teaching

• Explain drug therapy to patient. Assure him he will be monitored continuously.• As appropriate, review all significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

☞ Be aware that angioedema associated with life-threatening upper airway swelling may occur. If involvement of the tongue, hypopharynx, or larynx occurs, promptly discontinue drug and provide appropriate treatment.

Patient teaching

• Instruct patient to take tablet 1 hour before meals on an empty stomach or to take capsule in morning with water at least 1 hour before a meal.• Instruct patient not to consume alcohol within 2 hours of taking extended-release capsule.• Advise patient to consult prescriber before taking over-the-counter products such as antihistamines because these may increase risk of side effects.• Inform patient that drug increases risk of heat prostration; describe symptoms and advise him to seek prompt medical attention if these occur.• Caution patient to avoid driving and other hazardous activities until drug effects are known.• Advise patient to avoid alcohol use.• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

triamterene

A diuretic drug, C12H11N7, that allows potassium to be retained rather than eliminated in the kidney, often used in conjunction with hydrochlorothiazide.

triamterene

[trī·am′tərēn]

a potassium-sparing diuretic.

indications It is usually prescribed alone or with another diuretic in the treatment of edema, hypertension, and congestive heart failure.

contraindications Anuria, severe liver or kidney dysfunction, hyperkalemia, or known hypersensitivity to this drug prohibits its use.

adverse effects Among the most serious adverse effects are electrolyte disturbances, particularly hyperkalemia. GI disturbances also may occur.

triamterene

A K+-sparing diuretic that blocks resorption of sodium in the distal convoluted tubule of the kidney; it may be used alone, with a loop–eg, furosemide or thiazide diuretic–eg, hydrochlorothiazide, for managing HTN. See Diuretic, Potassium-sparing diuretic.

triamterene

A potassium-sparing diuretic drug used to relieve the body of excess water and to treat mildly raised blood pressure. Triamterene is formulated with another diuretic drug under the brand names Diazide, Dytide, Frusene, Kalspare and Triam-Co.

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